The social construction of depression : experience, discourse and subjectivity.

The thesis shifts the explanatory framework of depression from the currently
predominant clinical model which explains depression as a problem located in the
individual, to a social psychological approach which explains depression in terms of its
meaning to the individual, as an experience of self, evolved through relationships with
others. Theoretically, the thesis draws on Mead's (1934) theory of social hehaviourism,
and symbolic interactionism (Blumer 1969).
An innovative and interpretative qualitative methodology, "Thematic Analysis", is
developed for the analysis of interview accounts acknowledging the perspectives of
participants. Analyses are presented as the subjective interpretations of the researcher but
accounts are approached as partial representations of real experiences. The methodology
of thematic analysis is developed through the research, drawing on grounded theory
(Glaser and Strauss, 1967) and discourse analytic techniques (Potter and Wetherell,
1987).
The thesis comprises four separate studies to investigate subjective experiences of
depression and the meaning of the term "depression", based on in-depth, semi-structured
interviews. Study I, an exploratory study with a university population (not necessarily
depressed), identifies themes and discourses in accounts of depression. Study II
investigates subjective experiences of depression from patients' perspectives, based on
accounts of psychiatric out-patients and patients of general practitioners who had been
diagnosed as depressed, and identifies the power of the medical discourse in legitimating
problems as depression. Study III discusses medical discourses of depression, as used
by psychiatrists, general practitioners and clinical psychologists in interview accounts
which emphasised the importance of organisational context. Study IV investigates
women's experiences of motherhood and depression from participants' perspectives and
based on their subjective accounts, and discusses gender identity and the social
construction of motherhood as part of their experiences of depression.
The analysis indicated that for most respondents depression is both a subjective and a
socially constructed experience. The powerful construction of depression as a clinical
problem located in the individual may legitimate problematic experiences, hut it is
insufficient to explain subjective experiences of depression, which are better understood
in terms of the construction of subjectivity through social interaction. The research has
implications for more helpful professional and personal approaches to understanding the
experience of depression.